Coming to the realization that our loved ones may need elder care can be a difficult and emotional process. Feelings of guilt, even grief, often arise, and the emotional toll it can take on both you and your loved one can be significant. For many people, the difficulties begin when conflicts arise about whether an elderly loved one is capable of continuing to live independently or not. Your elderly loved one may feel betrayed or confused, and may be at odds with the family regarding their need for elder care.

This is the time for a family to come together and have a frank, open conservation to determine if elder care is the right choice. The only way to answer this question is to examine the current situation through an objective assessment. In other words, determining whether elder care is required should not be an emotionally driven decision; instead, an objective inventory of your loved one’s functional abilities and/or disabilities is needed to ensure a sound decision is made.

Here’s how to get started:

Determine Your Loved One’s Ability to Complete Activities of Daily Living (ADLs)

Activities of Daily Living (ADLs) simply mean the activities your loved one needs to accomplish on a daily basis to live safely and independently. Many families first notice a need for elder care when basic ADLs are not being accomplished. For example, your loved one may begin forgetting to take meds, or perhaps your loved one is just having some difficulty safely navigating through the house.

The inability to successfully complete even simple ADLs may jeopardize the health and well-being of your loved one, so it is important for family members to recognize what ADLs are not being accomplished at all, as well as what ADLs are beginning to become more difficult. ADLs serve as a trusted benchmark for families and medical professionals when determining whether an elderly loved one can continue to live independently.

It is wise to considered elder care when:

  • Your elderly loved one is unable to complete vital tasks, such as going to the bathroom unassisted, taking medication, preparing meals, safely moving about the house, etc.
  • Your elderly loved one has physical and/or cognitive impairments that prevent ADLs from being accomplished (e.g., wheelchair-bound, vision problems, arthritis, etc.).
  • Your elderly loved one requires medical care that cannot be self-administered (e.g., dialysis care, insulin injections, colostomy bag, etc.).
  • Your elderly loved one suffers from cognitive impairments that threaten their safety (e.g., forgets to lock doors, wanders away from the home, etc.)

It may also be a good idea for family members to ask themselves a number of questions regarding your elderly loved one’s current capabilities and faculties, such as:

  • Do they know how to safely exit the home in case of an emergency?
  • Do they know when to call 9-1-1?
  • Can they communicate effectively over the phone in case of an emergency?
  • Does their health history indicate the likelihood of a life-threatening medical emergency?
  • Do they know where their medication is located, what dose to take, and when to take it?
  • Do they possess adequate judgment not to let strangers into the house?
  • Can they handle their finances?
  • Can they use the shower/bathtub and toilet independently?
  • Can they prepare their own meals? Do they understand the importance of eating regularly?
  • Are they afraid to be alone in the house?
  • Are they lacking frequent social interactions? Are they lonely?

If in Doubt, Enlist the Help of Your Loved One’s Physician

An impartial, third party, such as your loved one’s physician, may be necessary to resolve disagreements between family members regarding declining health or physical limitations (assuming your loved one has given written consent allowing family members to discuss private patient information with a physician).

It is also important to remember that the nature or severity of your loved one’s impairments may not always be obvious to family members, so getting a better understanding by talking to a physician may be in order. Remember: better, more informed decisions are made when family members are armed with all relevant information.

Considering All the Options

Once the family agrees that elder care is required, an evaluation of possible options can begin. The type of care chosen will depend on a number of factors, including the type/level of care required, as well as financial constraints. For some seniors, elder care may mean in-home care or assistance, home modifications, and safety precautions, while for others, it may mean moving into an assisted living facility or nursing home, where medical care can be administered and where all ADL limitations are accommodated.

  • In-home care: Ideal for seniors who are still able to live at home independently but may require assistance/support/companionship from time to time
  • Independent living: Ideal for seniors who can successfully complete ADLs but may be seeking companionship and support through a senior community atmosphere
  • Assisted living: Ideal for seniors who are capable of living relatively independently yet may have some limitations that require assistance or on-site medical care
  • Nursing homes (skilled nursing): Suitable for seniors who require a high level of around-the-clock medical care and support; ideal for seniors recovering from illness or surgery or those with swiftly declining or serious health problems
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